Nasopharyngeal viral load predicts hypoxemia and disease outcome in admitted COVID-19 patients

By Shlomai A, Ben-Zvi H, Bendersky AG, et al
Published September 2, 2020

Key Takeaways

In this study, researchers focused on the clinical parameters that may accurately predict disease outcome in admitted COVID-19 patients and found an association between viral load measured around admission, lung inflammation, and disease outcome. Nasopharyngeal viral load is noted to be directly linked with hypoxemia, as well as with worse disease outcomes in admitted patients with COVID-19. Discussion was done concerning similarities and differences between related studies. The association between viral load and survival was examined in prior studies. In agreement with the results, a study of 678 admitted patients in New York identified significantly higher mortality among patients with a high viral load on admission vs those with low viral loads. In an older age cohort (n = 48, age 67–97) from Belgium, survival was predicted with clinical frailty scale, LDH, and viral load. Further, detectable viral RNA in anal swabs was positively correlated with intensive care unit (ICU) admission. In contrast, no correlation was noted between viral load and disease outcome in Swiss study. The study compared patients admitted to the ICU (n = 48) with patients treated in a screening unit (n = 723) in terms of viral load. However, it remained uncertain if these cases were later admitted, intubated, or survived. In a different New York study (n = 205), viral load was noted to have no association with disease severity parameters. However, non-hospitalized and hospitalized patients were mainly compared in this study. Among the various markers linked with COVID-19 severity, IL-6 is identified to be the most accepted one. However, at admission, IL-6 is not routinely examined and might indicate other inflammatory conditions. Thus, in spite of disparities in test kits and procedures between different laboratories and institutions, viral load possibly represents a rapid screening tool for assessing COVD-19 severity among admitted patients.

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